The EFPIA Disclosure Experience: An Update

Nine months on from the 2016 European Federation of Pharmaceutical Industries and Associations (EFPIA) Disclosure Code deadline - which required all member companies across Europe to publish data concerning their 2015 transfer-of-value transactions to healthcare professionals (HCPs) - EFPIA Director of Communications Andrew Powrie-Smith offered a lively update on the responses to the Code to a highly engaged audience at last week’s CBI’s Global Transparency Reporting Congress in London.

Having monitored the media reaction to the first wave of disclosures (or attempts at disclosure), Powrie-Smith pointed to generally neutral coverage across Europe, the negative perspectives tempered largely by time constrictions on reporting before the data could be properly analysed and, in many cases, a lack of understanding about what the data actually meant. When the media commentators have had time to grasp more fully the nature of transfer-of-value disclosures and begins to drill down in more detail-focusing on individual HCPs and prescribing data, for example-Powrie-Smith said that the coverage will likely become more informed and critical.

There has yet to be a sustained European response equivalent to that from US outlets such as ProPublica, who have been cutting the US “Sunshine” data every which way to come up with new and more provocative angles on the issues (for example, their 2014 story, “Almost No Women Among Medical Industry’s Top-Paid Speakers”), but Powrie-Smith did point to recent Irish headlines that highlighted confusion about the money trail from pharma to HCPs and HCOs (HSE Does Not Know If Any Senior Staff were Paid by Drug Companies, Irish Times, March 13, 2017). However, in an analysis of 338 European articles from the end of June last year, EFPIA could categorize only 19% as “negative”. Powrie-Smith highlighted writer and physician Ben Goldacre’s comments as a pretty example of “where we’re at”:

A financial conflict of interest does not necessarily mean that somebody is up to no good, but it does mean there are risks, and that they may be biased. That's why clearly declaring your conflicts matters, so that we can all judge for ourselves -The Telegraph (June 30, 2016).

With disclosure rates in Europe ranging from Spain’s 15% to Sweden’s 89%, the cultural expectancy around transparency still very much varies across the region, and the industry responses from member countries reflect this. Powrie-Smith pointed to four current approaches: the Netherlands and the UK, for example, are committed to making full transparency the standard approach; Greece, France and Denmark have made legislative requests for a central disclosure platform; in other countries, civil society groups have collected all the data together for publication; and in some European countries, disclosure data is still found only on company websites. Powrie-Smith commented that having these four different approaches “doesn’t make sense - if you are a proactive patient organization in a country that doesn’t have a central platform, that is an issue and we need to look how to manage that.” He added: “We can’t guarantee that the EFPIA disclosure code will take away the need for legislation, but it comes down to whether we can show a positive direction of travel across Europe. That is the most significant things in terms of resources, investment, and relationships with customers. Leadership in the medical community is important, but leadership in industry is really important. It is about establishing the architecture of the future that we would like to see around central platforms.”

Regardless of the different speeds with which EU member countries are adopting the transparency framework, Powrie-Smith reminded the audience that transparency is here to stay, and once a country gets on board there is no “going back”. The situation for HCPs working with pharma is no longer “Should I be transparent or not?”, but “Should I work with industry or not?” He concluded: “We have to think now about what the future looks like, not what we have been doing. There has been some leeway in year one, but self-regulation is the way ahead.”

Revisiting the issue of media perception on data disclosure later in the conference, Michael Bartke, former Director of Compliance Management at Daiichi Sankyo Europe, said he believes the EFPIA Disclosure Code to have been a success, because it did not provoke any media outrage and shone further light on the nature of pharma-HCP relationships. However, he added, the nature of co-operation between companies and HCPs is still not fully understood, and “it will still take time for disclosure to function properly”.